Keith Kantor, author of What Matters and chairman of a congressional panel on lowering health care costs, talks about how Obamacare may impact single people.
The Affordable Care Act popularly known as Obamacare was one of the most debated and controversial pieces of legislation in recent memory. You might need to go all the way back to the Civil Rights Bill of 1964 to see a piece of legislation that so sharply divided Americans. Several years later, with the Supreme Court having upheld the legislation, the changes have already begun. Why was this legislation so controversial? What was right with it? What was wrong with it? And how will it impact those who are not part of a traditional family structure?
Dr. Keith Kantor, author of What Matters and the former chairman of a House of Representatives’ commission on lowering health care costs answers some of these questions for Singular magazine.
Singular: Single adults are now almost half of the US population, with 28 percent of those living alone (31 million). Most of what we hear about Obamacare is addressed to its impact on families. Can you give us some insight as to how it might affect singles?
K. Kantor: The current Affordable Care Act (Obamacare) is based on trying to make insurance more affordable for families and low income households. So far, the numbers we see do not show this to be the case. The lower tier insurance policy for a family of 5 will have a reported price tag of $20,000 per year which is higher than most policies are now. The negative aspect, besides the price, is that the cost for singles will go up to try and make the cost for families and the elderly more affordable.
Singular: Singles are already impacted by tax laws that favor married households, how does the mandatory coverage fee/tax impact their tax structure?
K. Kantor: The taxes or penalties to try to force people to get insurance is actually very low, ranging from $60 a year to several hundred dollars after a few years. This tax is really too low to force someone to get insurance if they don’t want it, and it really won’t have a more negative effect on singles than it will on married couples.
Singular: Singles may be more impacted by catastrophic/long-term care costs since they won’t have a domestic partner or spouse, how is this dealt with under Obamacare? Is it even addressed?
K. Kantor: It is not addressed at this time under Obamacare, but same-sex couples are treated as married couples under the new law.
Singular: Single people who are self-employed don’t have the option of group health coverage or being added onto a partner’s plan. Are single people more likely to not have coverage and how will that change with Obamacare?
K. Kantor: Some self-employed have the option of joining groups in order to get what would be similar to group coverage and this doesn’t change under the new laws. The concept is for them to use the state exchanges to shop for the best rates. At this time we don’t know what those rates will be, but the concept was that competition would make these rates competitive.
Singular: For those who have group insurance from their employers or the government which has been defined as “Cadillac” insurance, will their out-of- pocket expenses increase as benefits decrease?
K. Kantor: I believe rates will increase on all insurance to make up for mandates such as allowing children to stay on their parents coverage until they are 26 and forcing insurance companies to accept people with pre-existing conditions. The companies have to remain profitable so rates will have to go up to pay for this. One of the factors will be higher deductibles and co-pays to help offset the higher costs to the insurance companies.
Singular: Is it true that Obamacare will impact payments to doctors and push independent physicians to join HMOs?
K. Kantor: I do not believe more doctors will join HMO’s, since the fees they receive will be greatly reduced. What is happening is more doctors will stop accepting HMO’s, Medicare and Medicaid and become concierge doctors where they charge a large fee ($5,000 per family) but only accept about 600 families and give great care. They then accept the regular insurance for the rest of the cost without co-pays and deductibles. This trend is growing and those with the means will be joining these doctors to avoid the long waits for appointments, waits in the office and short doctor visits.
Singular: For those single parents with adult children, whose insurance is responsible for extending benefits till the age of 26, what will happen to their premiums?
K. Kantor: The parents insurance is responsible and if there are 2 parents but they are divorced, the parent who is covering it now will still be the one to cover this. As I said, all rates will go up to help cover these mandated benefits.
Singular: Will single parents be penalized for not having coverage for their children even if they don’t have custody?
K. Kantor: I believe only the parents who have custody will have to cover the children but if the divorce agreement says a parent must provide insurance for the spouse and children then they will still be responsible for it.
Singular: How will Obamacare impact singles who are primary care givers for their elderly parents?
K. Kantor: Obamacare really doesn’t cover this but in theory the rates for the elderly will go down or not rise much while the rates for the younger singles will rise to help the companies compensate for the costs.
Singular: Singles who are close to retirement age, how does this affect their Medicare and Medicaid coverage, both short term and long term?
K. Kantor: The way the laws are written and all proposed new laws, if you are 55 or older, there will be no change in Medicare or Medicaid. I do not think this is true since the President took $716 billion dollars out of Medicare to help pay for Obamacare. He also lowered the fees paid by Medicare and Medicaid to doctors and hospitals, which is causing many of them to drop out of the programs which will increase the waits and shorten the visits which lowers the quality of care.
Singular: Anything else you would like to add about how Obamacare will impact people who are not legally married?
K. Kantor: The new law will cover same-sex couples, but those who are not married will tend to pay higher rates to help subsidize families, the elderly and the poor.